US 3206018 A
Description (OCR text may contain errors)
p 1965 N. F. LEWIS ETAL 3,206,018
WIRE SUTURING DEVICE Filed July 10, 1965 2 Sheets-Sheet l J INVENTORSI A/dAMA/Vf/EW/S ATN EY P 14, 1965 N. F. LEWIS ETAL 3,206,018
WIRE SUTURING DEVICE Filed July 10, 1963 2 Sheets-Sheet 2 INVENTORSI A/O/FMA/V r. [5M5 P4 4 5. fz' mv J/a United States Patent 3,206,018 WIRE SUTURING DEVICE Norman F. Lewis and Paul E. Regan, Jr., Somerville, N .J., assignors to Ethicon, Inc, a corporation of New Jersey Filed July 10, 1963, Ser. No. 293,960 8 Claims. (Cl. 206-635) The present invention relates to wire suturing devices, more particularly to wire suturing devices suitable for tendon surgery.
Tendon repair preferably is accomplished utilizing stainless steel wire sutures in either a buried suture or a pull-out suture technique. In the buried suture technique the sutures are left in the body after the damaged tendon heals, whereas in the pull-out suture technique the suture, or sutures, are removed after healing occurs. This invention is concerned with pull-out suturing with stainless steel wire.
According to this invention, a wire pullout suturing kit is provided for tendon repair wherein all of the sutures and devices needed for this surgical procedure are supported on a foldable card, The card is adapted to be folded to substantially enclose the sutures and unfolded to present the sutures and other devices in such a way that they are readily accessible.
The wire pull-out suturing kit of this invention comprises a wire repair suture secured to at least one, preferably two, straight suturing needles, .a wire pull-out suture secured to. a curved cutting needle, a holding 'button having a plurality of openings therein for suture threading, and a foldable card of relatively stilt material which comprises a first panel holding the repair suture and straight needle or needles, a second panel holding the pull-out suture and the curved needle, a third panel holding the button, and means detachably holding the panels together when they are superimposed and folded over one another in such a way as to substantially enclose the sutures and the button.
In the pull-out suture technique, the repair suture attached to the straight needle or needles is used to repair the tendon. During repair the first suture is attached to or threaded through the pull-out suture which preferably is in the form of .a loop. Atter repair the straight suture needles are run through the skin, threaded through the holes in the holding button, and then removed so that the repair suture ends can be secured to the button. The cutting needle is run through the skin on the opposite side of the repair to draw the pull-out suture into its final position. The button is positioned in such a way that the sutures extend between the repaired tendon and the button and apply tension to the repair to assure that the tendons do not separate before they are healed. After healing occurs, the sutures are removed by cutting oil the button and applying tension to the pull-out suture.
The holding button is mounted in a detachable portion of the third panel, referred to above and the detachable portion, or section, is adapted to be removed from the card with the button. Thus, the button can be positioned and handled by holding the detachable section. Preferably, the detachable section defines a frame portion surrounding a hole and the button, itself, includes mounting means adapted to snap into the frame. Preferably, a breaking line such as a line of spaced perforations is included in the section between the button and an edge of the section so that the button may be removed easily therefrom by tearing the removable section along the breaking line to free the button from the frame.
Means .are provided on the same side of the card when all of the panels are unfolded for holding the repair suture and the pull-out suture, or loop, in smooth curves 3,206,918 Patented Sept. 14, 1965 thereon. This is important since a suture may be unuseable for this type of surgery if it contains a sharp bend or kink.
Other and further advantages of this invention will be apparent from the following description and claims taken together with the drawings wherein:
FIG, 1 is a view in perspective of a Wire pull out suturing kit according to this invention inside a sterile strippa-ble package therefor;
FIG. 2 is an enlarged view partly in section and partly in elevation taken along the line 2-2 of FIG. 1;
FIG. 3 is a view in perspective of the opposite side of the wire suture and button k-it shown in FIG. 1 with the panels thereof folded over one another and held in position by a latch;
FIG. 4 is a view in perspective of the kit of FIG. 3 after the latch holding the panels together has been opened;
FIG. 5 is a view in perspective of the kit of the preceding figures with all panels unfolded except for the one holding the button;
FIG. 6 is an enlarged view of .the latching means for holding the panels in their folded position;
FIG. 7 is a more greatly enlarged sectional view taken along the line 77 of FIG. 6;
FIG. 8 is a plan view of the wire pull-out suturing kit of the preceding figures with all of the panels unfolded and the sutures and button in position;
FIG. 9 is an inverted plan view of the detachable portion of the third panel of the kit of the preceding figures;
FIG. 10 is an enlarged sectional view taken along the line .1010 of FIG. 8;
FIG. 11 is a schematic view showing the repair of a damaged tendon and illustrating the manner in which the wire pull-out loop is attached to the repair suture;
FIG. 12 is a schematic view of the sutures and tendon of FIG, 11 after the repair sutures have been attached to the holding button which, in turn, is positioned on the end of a finger, and the pull-out loop has been run through the underside of the finger.
Referring to FIGS. 1 and 2 of the drawings, there is shown a closed wire pull-out suturing kit 21 according to this invention inside a sealed strippa-ble envelope 22. The kit is held in its closed position .by a latch 23 which will be described more fully hereinafter. The strippable envelope 22 comprises a transparent top sheet 24 and a bottom sheet 25 sealed together along their edges to provide a hermetically sealed sterilizable enclosure for the kit. The line sealing the sheets is in the form of a shallow peak 26 at one end of the package and the peak is spaced somewhat from the adjacent ends of the sheets to provide stripping flaps 27 and 28 for opening the package. The flaps 27 and 28 are stripped apart to separate the sheets and break the seal when it is desired to remove the kit 21 from the package. Printing 29 normally is applied to one side of the kit 21 to identify its contents and the kit is inserted in the envelope 22, with the printing positioned so that it may be read through the transparent side of the envelope to identify the product.
Referring to FIGS. 3- 10 of the drawings, in particular, there is shown a wire pull-out suturing kit 21 according to this invention which comprises a Wire repair suture 31 having a straight suturing needle 32 secured to each of its ends; a wire pull-out suture loop 33 secured to a curved needle 34; a holding button 35 having a plurality of openings, or holes, 36 therein; and a foldable card 37 of relatively stiff material which card comprises a first panel 38 holding the repair suture 31 and straight needles 32, a second panel 39 holding the loop 33 and curved needle 34, a third panel 41 holding the button 35 and a fourth panel 42 presenting a latching flap 43 for holding the panels in their folded over positions. The second panel 39 is foldably connected to the first panel 38 along'a comm-on longitudinal edge 44, the third panel 4 1 is foldably connected to the second panel 39 along a common transverse edge 4-5, and the fourth panel 4 2 is foldably connected to the second panel 39 along a common longitudinal edge 46; and the first, third and fourth panels are adapted to be folded over one another and over the second panel in such a way that the panels substantially enclose the repair suture 31, the loop 33, and the button 35. As shown in FIG. 5, the third panel 41 holding the button is folded over the second panel to substantially cover the pull-out loop 33 and cutting needle 34 and then the first panel 38 holding the repair suture 31 and straight needles i 32 is folded down over the third panel 4 1, as shown in FIG. 4. Next the fourth panel 42 is folded over the first, third and second panels and the latching flap 43 is folded over the back of the second panel, as shown in FIG. 3. latching flap 43 presents a detent 47 which is adapted to be folded inwardly in such a way that it can be inserted in a correspond-ing cut-out, or slot, 48 in the back. of the second panel as to form a latch 23 for detachably holding the panels in their folded-over positions. 6 and 7, the latch is shown in its closed position.
The card 37 is cut, or stamped, and folded from a single sheet of relatively stiff material such as virgin paperboard approximately 0.01" thick, and preferably is coated or treated so that it is water and blood-stain resistant. The first and second panels 38'and 3-9 of the card each include a series of tabs 49 partially cut in the panels in such a way that the repair suture 31 and the loop 33 may be positioned'over or threaded between the tabs 49 and the adjacent panel surface in smooth curves on one side of their respective panels and on the same side of the card when the panels are unfolded, as shown in FIG. 8. Tabs 50 also are provided for holding the needles securely in position on the panels.
The portion of the third panel 41 supporting the button 35 is in the form of a section 51 which is detachable from the card by tearing along a line of perforations 52 at one edge of the section. This detachable section 51 is cut to form a hollow frame portion 53 defining a hole in which the holding button 35 is adapted to fit. The button 35, in turn, is in the form of a hollow domehaving a flange 54 around its base and a set of six ridges 55 extending radially from the dome and spaced from the flange 54 to accommodate the thickness of the card at the frame. The flange 54 and the ridges 5-5 cooperate to act as mounting means for securingthe button 35 in the frame 53. The button 35 is. pressed into the hole in the frame 53 from the underside of the frame until the ridges 55 snap through the hole andthe button is mounted-on the detachable section 51 with the frame positioned between the flange 54 and the ridges 55, as shown most clearly in FIGS. 8, 9 and 10. A perforated breaking line 56 is included between the button 35 and the bottom edge of the detachable section for facilitating removal of the button therefrom. When it is desired to separated the button from the section, the card is torn along the breaking line so that the button no longer is held by the frame.
FIG. 11 illustrates repair of a damaged finger tendon 57 using the kit of this invention. The repair suture 31 has been criss-crossed through the right and left tendon ends to make the repair and passed through the pull-out loop 33 at the right end of the repair. Thus, after the repair has been completed, the two ends of the repair suture 31 attached to the straight needles 32 are positioned at one end of the repair and the pull-out loop 33 attached to the curved cutting needle 34 is positioned at the other end of the repair, as shown in FIG, 11. Then, the button 35 is positioned in the proper place on the end of the finger to apply tension to the parts being repairedand the repair suture ends are threaded through a As shown particularly in FIGS. 6 and 7, the T In FIGS. (i
pair of holes in the button. The straight needles G2 are removed therefrom and the suture ends are tied or otherwise secured to the button to apply the desired tension to the repair. The cutting needle 34 is run .through the finger on the other side of the repair and removed from the loop to leave portions 58 of the pull-out suture available for later removal of the sutures from the finger.
Having now described the invent-ion in specific detail and exemplified the manner in which it may be carried into practice, it will be readily apparent to those skilled in the art that innumerable variations, applications, modifications, and extensions of the basic principles involved may be made without departing from its spirit or scope.
The invention claimed is:
1. A suturing package which comprises a suture holding button having a plurality of openings therein, and a foldable card of relatively stiff material, which card comprises a first panel, a second panel, and a detachable section holding said button, said first and second panels and said detachable section being foldably connected to one another and adapted to be folded over and superimposed, one upon the other, in such a way that the panels substantially enclose said detachable section, said detachable section defining a hollow frame portion and said button comprising mounting means adapted to snap into said frame portion for securingsaid button in position in said detachable section.
2. A suturing package according to claim 1, wherein "I said mounting means defines a peripheral shelf adapted to fit within said frame.
3. A suturing package according to claim 1, which furthercomprises a third panel foldably connected to one of said first and second panels, said third panel including means for cooperating with corresponding means presented by one of said other panels and forming a latch for detachably holding said panels in their folded over positions.
4. A Wire pull-out suturing kit according to claim 1,
1 wherein a breaking line is included in said detachable needle, a second panel holding said pull-out suture and said cutting needle, a third panel holding said button, said first, second and third panels being foldably connected to one another and adapted to be folded over and superimposed one upon the other, and means detachably holding said panels in their folded over positions, the
portion of said third panel holding said button being detachable from said card and said button comprising mounting means for positively positioning the button on the detachable portion of said third panel.
6. A wire pull-out suturing kit according to claim 5, wherein said detachable portion of said third panel defines an open frame and said button mounting means is adapted to snap into said frame for securing said button in position in said detachable portion.
A 7. A wire pull-out suturing kit according to claim 6, wherein said mounting means defines a peripheral shelf adapted to fit within said frame.
8. A wire pull-out suturing kit according to claim 6, wherein a breaking line is included in the detachable portion of said third panel between an edge of said third panel and said button and the panel is adapted to be broken along said line to facilitate removal of the button therefrom.
References Cited by the Examiner UNITED STATES PATENTS 6 FOREIGN PATENTS 739,347 10/55 Great Britain. 340,948 10/59 Switzerland.
Fisher 20679 Eggfig 128*335 5 THERON E. CONDON, Primary Examiner. Thorpe 206 79 GEORGE O. RALSTON, Examiner.